Special Post: Pregnancy and Coronavirus

In the last several weeks, we have entered uncharted waters as health care providers and patients. As you may know by now, the Novel Coronavirus, also known as COVID-19, originated in China and has spread through many countries, including the United States.

As the situation evolves, the US federal and state governments are taking new precautions, screening measures, and plans to ensure our safety.

But the reality is, many of us have felt some sort of fear, anxiety or panic.

First and foremost, do not panic. This is an ever-evolving situation. There will be a time in the near future where more information is gathered and the situation will appear worse than it is. This is especially true as we do more tests.

Again! Don’t Panic!

Continue to take the necessary precautions (as discussed below).

This post was not written to further ignite fear or spread concern, rather educate pregnant women, their partners and their team about this virus. This situation is ever-evolving and the information presented here today may and will change.

The American College of Obstetrics and Gynecology (ACOG), Center of Disease Control (CDC), World Health Organization, and the like are the resources that I am drawing most of my information from. Presently there is limited information and research studies evaluating the effect of COVID-19 on pregnant women and their fetuses. From the studies that have been conducted, there were a limited number of patients to evaluate (18 total). This number will change.

Lets get to it:

The basics! What is the COVID19?

This is the name designated for the disease that is caused by the virus SARS-CoV-2.

It is presently found to be transmitted person-to-person via respiratory droplets, similar to the spread of influenza (the common flu). That means anyone that is infected, and then coughs or sneezes, the virus can travel and enters mucous membranes (i.e. mouth, nose, etc) of another person. It can also be transmitted by touching infected surfaces and then touching your eyes, nose, or mouth.

Incubation Period

2 – 14 days (avg. 5 days)

Who can be infected?

Any age (more common in middle age and older patients)

Signs and Symptoms

Most Common: Fever, fatigue, dry cough, body aches, shortness of breath

How are pregnant women affected?

There is limited information on whether pregnant woman are actually at greater risk. However, throughout pregnancy, a woman will experience changes to their physiology, including their immune system. They are at increased risk of infection.

In studies on the flu and other coronavirus, mothers in the first trimester are at risk for certain birth defects if they experience high fevers. Miscarriage and stillbirth are also observed during pregnancy.

Overall, with the limited data on COVID19, pregnant women and the fetuses do not appear to be at increased risk for severe disease.

So…What precautions should be taken by pregnant women?

  • Standard precautions – Wash your hands! Avoid people who are sick! Clea
    Wash your hands often with soap and water or alcohol sanitizer
  • Airborne Precautions – Per the CDC, wearing a mask has a limited impact on limiting the spread of disease unless you are symptomatic.
  • When in labor or post-delivery, hospitals are likely to limit visitors to one (this is a case by case basis)

Can Coronavirus be transmitted from mother to fetus? Mother to baby after birth?

A study of 18 women in china, there were no cases found of mother to fetus transmission. There have been no cases where the virus is found in amniotic fluid or breastmilk.

What about breast feeding?

It is unknown if the virus can be transmitted through breast mild. At this time, there should be no restriction in breast feeding. If you are feeling ill or are positive with COVID19, covering your face with a mask and taking all hygiene precautions is recommended.

What should I do if I feel ill or symptomatic?

  • Call your doctor or OBGYN; DO NOT GO TO THE OFFICE OR EMERGENCY ROOM. This will allow us to evaluate and determine the extent of your illness before placing you in an area that could infect others.
  • Testing is recommended if:
    • Patient has a fever and cough/shortness of breath that does not require hospitalization, and they have
    • Traveled to domestic or international affected areas within 14 days of onset of symptoms
    • Or Other exposure as indicated by the patient’s history
  • With the new availability of tests per the US government task force for COVID19, recommended testing may be for:
  • Persons who develop a respiratory illness in non-health care settings (schools, dormitories)
  • Older individuals (>65 years old)
  • Individuals with chronic medical conditions and/or immunocompromised

What if I have or suspected to have COVID-19 and I go into labor?

Notify your doctor and the hospital PRIOR to your arrival. This allow the hospital the appropriate amount of time to prepare.

As we move forward, and more information becomes available, I will update this blog with regards to pregnancy as frequently as I can. If you have questions, feel free to contact me or contact your OBGYN with your questions. It is best to gather as much information and be as informed as possible.

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Daniel Niku, MD, MS

Call Us: (310) 652-9347

Visit Us: 150 North Robertson Boulevard Suite 200
Beverly Hills, CA 90211

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